Exercise for Cancer Survivors

by Claudio Battaglini, PhD, and Denise Spector, PhD, RN

It has been estimated that the
number of cancer survivors
in the United States exceeds
13 million and is continually growing
thanks to improvements in both early
detection and cancer treatments. This is
great news! However, cancer survivors
often have unique healthcare needs that
can significantly affect their quality of
life, both physically and emotionally.

In addition to the physical and psychological
effects from diagnosis and
treatment, some cancer survivors are
at increased risk for recurrence and
comorbidities, such as weight gain,
cardiovascular disease, diabetes, osteoporosis,
and secondary malignancies.
Many cancer survivors are motivated to
make positive life changes and often ask
their doctors what they can do to help
improve their health during and after
cancer treatments. Part of the answer
may be exercise.

The Benefits
Exercise has long been
recognized in many areas of medicine as
an effective way to promote health and
prevent disease. Over the past several
years, there has been an accumulation of
supportive evidence on the benefits of
physical activity among cancer survivors,
during active treatment and beyond. Exercise
training among cancer survivors
appears to be safe, is well tolerated, and
has been shown to improve physical
function, cardiorespiratory fitness, body
composition, fatigue, anxiety, depression,
and overall quality of life. Some
studies have shown that physical activity
after a cancer diagnosis is associated
with a reduced risk for recurrence.

Some studies have shown that physical activity
after a cancer diagnosis is associated with a
reduced risk for recurrence.

Physical Activity Guidelines
Both
the American Cancer Society and the
American College of Sports Medicine
have published exercise guidelines for
cancer survivors based on scientific
evidence of the safety and efficacy of
exercise interventions. For adult cancer
survivors, both these organizations
support the United States Department
of Health and Human Services 2008
Physical Activity Guidelines for Americans.
These guidelines include the
following:

Avoid inactivity and return to normal
daily activities as soon as possible.

Engage in at least 150 minutes of
moderate intensity aerobic physical
activity a week or 75 minutes of vigorous
intensity
activity a week.

Engage in
strength-training
exercises involving
all major
muscle groups
two to three
days a week.

In addition
to these general
guidelines, the
American College of Sports Medicine
has developed cancer site-specific
guidance for exercise training prescriptions.
Within these guidelines, there are
specific precautions that should be followed
for those individuals with severe
anemia, fatigue, immune dysfunction,
and other chronic diseases. You should
consult with your doctor prior to beginning
any new exercise program to
determine whether you need to follow
any specific precautions.

Tips for Getting Started
Combining
strength and aerobic training is the best
way to reap the multiple benefits of exercise.
For aerobic training, a simple (brisk)
walking routine may be the best way to
start – it’s easy and it’s free! For resistance
training, you can start with latex
resistance bands or lightweight dumbbells.
Consider beginning with 10 to 20 minutes
of intermittent or continuous activity,
and gradually increase to 30 minutes of
continuous activity at least 5 days a week
(progression will be slower for those
who are deconditioned and those experiencing
severe side effects). Start with
light to moderate intensity. Initially increase
frequency and duration, and then
increase intensity.

There is no evidence that one type
of exercise is superior. For aerobic activity,
some may prefer swimming, and
others may opt for biking. The key is to
be flexible – modify exercise based on
your physical condition each day.

♦ ♦ ♦ ♦ ♦

Dr. Claudio Battaglini is an associate professor
in the department of Exercise and
Sport Science at the University of North Carolina
at Chapel Hill, UNC-CH Lineberger
Comprehensive Cancer Center Full Member
of Cancer Prevention and Control, and the
director of the UNC-CH Integrative Exercise
Oncology Laboratory. Dr. Denise Spector
is an oncology nurse researcher and cancer
health disparities post-doctoral fellow at the
School of Global Public Health and department
of Exercise and Sport Science at the
University of North Carolina at Chapel Hill.

The American Cancer Society’s “Nutrition
and Physical Activity Guidelines for Cancer
Survivors” is published online in CA: A Cancer
Journal for Clinicians at onlinelibrary.wiley.
com. The American College of Sports Medicine’s
guidelines can be found at
acsm.org
by entering exercise guidelines for cancer
survivors in the search bar.

This article was originally published in Coping® with Cancer magazine,
July/August
2012.